Association between tooth loss and adherence to oral maintenance in a dental clinic: A retrospective study of more than 20 years.

OBJECTIVES: The relationship between adherence to professional oral maintenance visits and tooth loss is generally accepted in periodontal treatment; however, this relationship has not been clarified in general dental practices. We evaluated the effectiveness of adherence to professional maintenance by a retrospective survey in a private practice. METHODS: We retrospectively extracted data of 395 patients in a general dental practice who had been followed for more than 20 years. For comparisons, two patient groups were created based on oral maintenance rates: a high- (≥75%) and a low- (<75%) adherence groups. Additionally, multiple logistic regression analysis for tooth loss was conducted with the same two adherence groups and three adherence groups (<50%, ≥50% and <75% and ≥75%), adjusting with risk factors including sex, age, decayed, missing, and filled teeth (DMFT), periodontal status, smoking status, and diabetes at the beginning of maintenance. RESULTS: The number of teeth lost and increased DMFT over time were significantly lower in the high-adherence group than in the low-adherence group. Multiple logistic regression analysis for tooth loss in the two adherence groups yielded an odds ratio (95% confidence interval) of 6.50 (3.73-11.32) in the low-adherence group relative to the high-adherence group. Further analysis with the three adherence groups showed highest risk in the low-adherence group and a higher risk in the moderate-adherence group than the high-adherence group. CONCLUSIONS: Patients with high adherence to maintenance schedules for more than 20 years demonstrated significantly less tooth loss. Dental practitioners should promote high adherence to professional maintenance in general dental practices.

Perceived stress and career planning awareness of Japanese and Taiwanese undergraduate dental hygiene students.

Background/purpose: Dental hygiene students' stress might be rising with increasing undergraduate study content and expansions in dental hygienists' roles and expectations as society changes. This study explored Japanese and Taiwanese dental hygiene students' perceptions of stress and their idea of career planning. Materials and methods: Participants were second- to fourth-year students in the 2020 academic year at Tokyo Medical and Dental University (TMDU; n = 60) and Taipei Medical University (TMU; n = 62). An anonymous questionnaire was distributed, which included questions on demographic information and career planning, as well as the Perceived Stress Scale-10 (PSS-10) and modified Dental Environment Stress questionnaire (DES). Results: The response rates were 100.0% (TMDU) and 96.8% (TMU). The number of participants who chose dental hygiene as the first program choice (P < 0.001) and wished to work as dental hygienists after graduation (P = 0.018) in TMDU was significantly higher than in TMU. There was no significant difference between the two schools' stress levels in both PSS-10 and DES-26. The factors influencing students who wished to work as dental hygienists after graduation were "clinical year or not" (P = 0.007) in TMDU, and the DES factor included items related to lack of confidence in becoming a successful and competent dental hygienist, expectations, and fear of the future (P = 0.033) in TMU. Conclusion: Both schools' students experienced moderate or relatively low levels of stress. TMDU students had higher stress related to academic studies, while TMU students had slightly higher stress related to future anxiety.

Effects of two-year oral health information provision on changes in gingival crevicular fluid in male day-night shift workers.

Background/purpose: Although dental diseases are related to systemic diseases and daily habits and are known to affect the quality of life, little attention has been paid to the importance of oral hygiene in Japanese working-age adults. We, thus, aimed to assess changes in the periodontal condition of working-age adults after providing regular oral health information at their workplace for two years. Materials and methods: Two years of oral health information were provided to workers at four printing companies. The effectiveness thereof was assessed using gingival crevicular fluid (GCF) test results-lactoferrin (Lf), alpha-1-antitrypsin (AT), and aspartate aminotransferase (AST). Questionnaires on health literacy (HL) and dental terminology were also administered to the workers during annual check-ups. Results: The baseline survey participants included were 234 male workers, of which 104 workers followed the same work schedule/day-night shifts and completed the two-year follow-up survey were examined. Providing continuous oral health information with regular updates did not improve participants' self-administered GCF tests (Lf: P = 0.272, AT: P = 0.723, and AST: P = 0.067), and there were no significant changes in HL, perceived symptoms, and use of interdental cleaning tools. Conclusion: Direct oral health education or examination might be necessary for working-age adults to achieve optimum oral conditions, and one-on-one health information provision might not improve their oral condition. A combination of methods to provide oral health promotion must be considered.

Dental Hygiene Learning Outcomes Obtained Through Computer-Assisted Simulation Modules.

Purpose: Education reflecting current knowledge is required for competent health care providers but the number of educators and/or lecture/clinical contact hours are often limited. The purpose of this study was to evaluate the learning outcomes and practicality of interactive simulation modules developed for a computerized learning system in dental hygiene education.Methods: Twenty-nine Japanese fourth-year dental hygiene undergraduates were given access to five interactive modules, delivered via a learning management system (LMS), for one month. The modules provided virtual clinical settings to take learners through decision-making processes for explaining procedures and treatments, and making appointments in English. Pre- and post-tests and a questionnaire were used to evaluate the knowledge gained and to receive learner's feedback. Participants were classified into two groups (study group and non-study group), based on their use/non-use of modules made available during the five-week period for statistical analysis.Results: Post-test scores were significantly higher in the study group (n = 22) than in the non-study group (n = 6), (p = 0.024). Post-test scores were also significantly higher than the pre-test scores in the study group (p = 0.001). No significant differences in the post- versus pre-test scores were found in the non-study group. The questionnaire response rate of 100% (n = 29) indicated that participants considered the interactive modules, including the system operation, as convenient and beneficial.Conclusion: Modules made available via a LMS for self-study were beneficial for Japanese undergraduate dental hygiene students in the acquisition of knowledge and skills for clinical decision-making in English.

[Return-to-work support programs for workers on sick leave: a systematic review and meta-analysis].

OBJECTIVES: We are responsible for answering the research question, "Does a return-to-work program improve the returning outcome?" This is one of the six research questions in the evidence-based "Return-to-work Guidance in Occupational Health 2017" developed by the Kanto branch of the Japanese Society of Occupational Health. This study aimed to integrate the effectiveness of the return-to-work program to improve the state of sick-listed employees suffering from cardiovascular disease, cancer, and musculoskeletal and mental health problems. METHODS: Three different databases, PubMed, Cochrane Library, and Ichushi-Web were searched. Based on the results of a systematic review, the guidance developing group created the draft of the recommendations with evidence to decision framework and used a poll to determine the recommendations. We integrated the evidence from a systematic review and meta-analysis at the disease level. This study protocol was registered with PROSPERO (the registration number is: CRD42016048937). RESULTS: A total of five articles on musculoskeletal diseases and six on mental health problems were retrieved. No articles in the cardiovascular and cancer areas matched the eligibility criteria. When workers suffered from musculoskeletal disorders, the rehabilitation group statistically returned to work earlier than the usual care group did [HR 1.58 (95% CI 1.26-1.97), -40.71days (95% CI -60.69--20.72) ]. In the mental health problems group, the psychological intervention program group had statistically less days of sick leaves as compared to that in the usual care group [-18.64 days (95% CI -27.98--9.30) ]. CONCLUSIONS: It might be suggested that work environment management, work management, tackling psychological problems, cognitive behavioral approach, and several meetings with supervisors and occupational health staff, in addition to a direct focus on backache contributed to the early return-to-work of workers suffering from musculoskeletal disease. Regarding mental health problems, interviews with a psychological approach and consultations with psychologists and psychiatrists might be effective in reducing the days of sick leaves. However, because these methods were investigated in Europe, we need to be careful when introducing these practises in Japan due to the differences in the occupational health support systems. Further, high quality evidence level studies are needed in Japan.

[Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"].

OBJECTIVE: "Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017." MATERIALS AND METHODS: The guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources. RESULTS: Based on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6. DISCUSSION AND CONCLUSION: From the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

Biochemical Gas Sensors (Biosniffers) Using Forward and Reverse Reactions of Secondary Alcohol Dehydrogenase for Breath Isopropanol and Acetone as Potential Volatile Biomarkers of Diabetes Mellitus.

This study describes two biosniffers to determine breath acetone and isopropanol (IPA) levels and applies them for breath measurement in healthy subjects and diabetic patients. Secondary alcohol dehydrogenase (S-ADH) can reduce acetone and oxidize nicotinamide adenine dinucleotide (NADH to NAD+) in a weak acid environment. NADH can be excited by 340 nm excitation lights and subsequently emit 490 nm fluorescence. Therefore, acetone can be measured by the decrease in NADH fluorescence intensity. S-ADH can also oxidize IPA and reduce NAD+ to NADH when it is in an alkaline environment. Thus, IPA can be detected by the increase of fluorescence. The developed biosniffers show rapid response, high sensitivity and high selectivity. The breath acetone and IPA analysis in healthy subjects shows that the mean values were 750.0 ± 434.4 ppb and 15.4 ± 11.3 ppb. Both acetone and IPA did not show a statistical difference among different genders and ages. The breath acetone analysis for diabetic patients shows a mean value of 1207.7 ± 689.5 ppb, which was higher than that of healthy subjects (p < 1 × 10-6). In particularly, type-1 diabetic (T1D) patients exhaled a much higher concentration of acetone than type-2 diabetic (T2D) patients (p < 0.01). The breath IPA also had a higher concentration in diabetic patients (23.1 ± 20.1 ppb, p < 0.01), but only T2D patients presented a statistical difference (23.9 ± 21.3 ppb, p < 0.01). These findings are worthwhile in the study of breath biomarkers for diabetes mellitus diagnosis. Additionally, the developed biosniffers provide a new technique for volatolomics research.

An Inter- and Intraprofessional Education Program in Which Dental Hygiene Students Instruct Medical and Dental Students.

The aim of this study was to develop, implement, and evaluate an inter- and intraprofessional education program with a peer support joint practice in which dental hygiene students teach medical and dental students about oral health care for older people requiring long-term care. In 2015 at Tokyo Medical and Dental University, 22 dental hygiene students in their third year at the School of Oral Health Care Sciences (OH3), 110 students in their third year at the School of Medicine (M3), and 52 students in their third year at the School of Dentistry (D3) participated in this program. The OH3 students practiced with a whole-body-type simulator to learn oral health care for older people and then taught the methods to the M3 and D3 students according to their self-designed teaching plan. All M3 and D3 students experienced being both practitioner and patient. The number of respondents and response rates on the questionnaires after the training were 22 (100%), 102 (92.7%), and 52 (100%) for the OH3, M3, and D3 students, respectively. Self-assessment by the OH3 students indicated that they could supervise other students sufficiently (77-86%), and 91% of them found the preclinical practice with the simulator efficient for the peer support joint practice. Almost all the M3 and D3 students reported that they gained understanding of the methods (99%), significance (100%), and important points of oral health care for older people (97%) in addition to the jobs and roles of dental hygienists (93%) because of this program. The M3 students understood the methods and significance of oral health care more deeply than did the D3 students (p<0.05). This study found that an interprofessional program with a peer support joint practice to cultivate practical clinical ability aided in increasing understanding and cooperation between medicine and dentistry.

[Relationship between oral health status and life behavior in junior and senior high school students in Japan].

A survey of dental diseases carried out by the Ministry of Health, Labour and Welfare in 2003 revealed that more than 40% of people aged between 5 and 25 suffer from periodontal diseases and the average number of DMFT has been decreasing. The lifestyle of junior and senior high school students in particular has changed drastically. This study investigated the relationship between dietary habits and oral diseases in junior and senior high school students in Tokyo. Survey responses were received from 813 of 848 students. There was a significant correlation between the presence of untreated teeth and student's dietary habits, or the presence of periodontal diseases. These results suggest that dental hygienists need to consider providing advice on appropriate eating habits during dental hygiene instruction to students.

Turbidity of mouthrinsed water as a screening index for oral malodor.

OBJECTIVES: The objectives of this research were to examine the relationship between turbidity of mouthrinsed water and oral malodor, and to evaluate whether the turbidity could be used to screen oral malodor. STUDY DESIGN: The subjects were 165 oral malodor patients. Gas chromatography and organoleptic test (OT) were used for oral malodor measurement. Oral examination along with collection of saliva and quantification of bacteria was conducted. Turbidity of mouthrinsed water was measured with turbidimeter. Logistic regression with oral malodor status by OT as the dependent variable and receiver operating characteristic (ROC) analysis were performed. RESULTS: Turbidity had a significant association with oral malodor status. In addition, ROC analysis showed that the turbidity had an ability to screen for presence or absence of oral malodor. CONCLUSION: Turbidity could reflect or represent other influential variables of oral malodor and may be useful as a screening method for oral malodor.

The relationship between turbidity of mouth-rinsed water and oral health status.

OBJECTIVES: The purpose of this study was to examine the relationship between turbidity of mouth rinsed water and oral health status such as dental and periodontal conditions, oral hygiene status, flow rate of saliva and oral bacteria. MATERIALS AND METHODS: Subjects were 165 patients who visited the Dental Hospital, Tokyo Medical and Dental University. Oral health status, including dental and periodontal conditions, oral hygiene status and flow rate of saliva, was clinically examined. The turbidity was measured with a turbidimeter. Quantification of Fusobacterium spp, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and total bacteria levels was performed using real-time PCR. The Pearson correlation and multiple regression analysis were used to explore the associations between the turbidity and oral health parameters. RESULTS: The turbidity showed significant correlations with the number of decayed teeth and deep pockets, the plaque index, extent of tongue coating and Fusobacterium spp, P. gingivalis, T. forsythia, T. denticola and total bacteria levels. In a multiple regression model, the turbidity was negatively associated with the flow rate of saliva and positively associated with the total number of bacteria (p < 0.001). CONCLUSION: Current findings suggested that turbidity of mouth rinsed water could be used as an indicator to evaluate oral health condition and the amount of bacteria in the oral cavity. In addition, the turbiditimeter appeared as a simple and objective device for screening abnormality of oral health condition at chair side as well as community-based research.

Functional tooth units and nutritional status of older people in care homes in Indonesia.

OBJECTIVES: To investigate the relationship between functional tooth units (FTUs) and nutritional status. METHODS: One hundred females (mean age: 72.4 ± 8.2 years) at four private care homes in Jakarta, Indonesia were interviewed and clinically examined. The oral examination included the assessment of teeth, prosthetic status, and number of FTUs. The total number of FTUs was further divided by tooth composition: natural tooth against natural tooth (NN-FTUs), natural tooth against denture (ND-FTUs), and denture against denture (DD-FTUs). Nutritional status was evaluated using the body mass index (BMI) and the Mini Nutritional Assessment (MNA). RESULTS: The mean numbers of teeth present, NN-FTUs, ND-FTUs, DD-FTUs, and total FTUs were 13.1 ± 10.4, 1.7 ± 3.0, 1.2 ± 3.3, 0.4 ± 1.2 and 3.3 ± 4.4, respectively. The mean BMI and MNA scores were 24.8 ± 5.0 and 22.6 ± 2.8, respectively. Subjects with a normal BMI had a significantly higher total number of FTUs (3.6 ± 4.6) compared with underweight subjects (0.1 ± 0.3). Subjects with a normal MNA had a significantly higher number of NN-FTU (2.6 ± 3.7) compared to those who were at risk or in a state of under-nutrition (1.2 ± 2.4). CONCLUSION: This study revealed significant relationships between the number of FTUs and nutritional status. Keeping the posterior occlusion should be emphasized in order to maintain good nutritional status in older subjects.

The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

OBJECTIVE: This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. MATERIALS AND METHODS: The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. RESULTS: Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. CONCLUSION: Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health habits are suggested to lead to better oral health for the elderly, and vice versa.

Factors affecting oral malodor in periodontitis and gingivitis patients.

AIM: To examine the associations between oral health status, the presence of N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria, and oral malodor in periodontal patients. METHODS: A total of 137 periodontitis and 80 gingivitis patients were included in the study. Oral malodor was measured by an organoleptic test and the OralChroma. An oral examination was conducted, including the assessment of decayed teeth, periodontal status, and tongue coating. The presence of N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria in the subgingiva, tongue coating, and saliva was evaluated by the N-benzoyl-DL-arginine-2-naphthylamide test. RESULTS: In the periodontitis group, oral malodor was significantly correlated with decayed teeth, periodontal parameters, and tongue coating. Among the N-benzoyl-DL-arginine-2-naphthylamide test parameters, the highest correlation of oral malodor was found with N-benzoyl-DL-arginine-2-naphthylamide subgingiva, followed by N-benzoyl-DL-arginine-2-naphthylamide tongue coating and N-benzoyl-DL-arginine-2-naphthylamide saliva. In the gingivitis group, oral malodor was significantly correlated with the plaque index, bleeding on probing, and tongue coating. Among the N-benzoyl-DL-arginine-2-naphthylamide test parameters, the highest correlation of oral malodor was found with N-benzoyl-DL-arginine-2-naphthylamide tongue coating, followed by N-benzoyl-DL-arginine-2-naphthylamide saliva and N-benzoyl-DL-arginine-2-naphthylamide subgingiva. CONCLUSION: Dental plaque, bleeding on probing, tongue coating, and N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria contribute to oral malodor, but with different degrees in periodontitis and gingivitis patients.

The effects of professional oral health care on patients in the subacute stage of emergent neurosurgical disorders.

This study evaluated the effectiveness of professional oral health care (POHC) on patients who were in the subacute stage of neurosurgical disorders. Forty subjects (26 male, 14 female) with acute cerebrovascular disorders or neurotrauma were randomly divided into two groups. The intervention group (n = 21) received POHC treatment by dental hygienists, and the control group (n = 19) did not. To evaluate the change in oral health status of the subjects, an oral examination was carried out at baseline and four weeks later. For the subjects in the intervention group, periodontal condition, oral hygiene status, and oral function improved statistically significantly. The detection rate for methicillin-resistant Staphylococcus aureus (MRSA) was statistically significantly lower in the intervention group than in the control group. These results suggest that POHC performed by dental hygienists in collaboration with nurses plays an important role in the promotion not only of oral health but also of general health.

Comparison between self-perceived and clinical oral malodor.

OBJECTIVES: The aims were to compare self-perceived with clinical oral malodor and to examine risk factors of oral malodor. STUDY DESIGN: The study was performed on 565 dental patients. Information on sociodemographics, dental health behavior, and self-perceived oral malodor was collected. Clinical oral malodor, oral health status, and the proteolytic activity of the N-benzoyl-DL-arginine-2-napthilamide (BANA) test in tongue coating were assessed. RESULTS: The sensitivity and specificity of self-perceived oral malodor were 47.2% and 59.2%, respectively. Risk factors for self-perceived oral malodor were smoking habit and alcohol consumption, whereas those for clinical oral malodor were level of education, dental visit frequency, tongue-brushing frequency, mouth rinse use, deep periodontal pockets, gingivitis, tongue coating, and a high BANA test score. CONCLUSIONS: Self-perception was considered an invalid method of judging one's own oral malodor. Factors related to self-perceived oral malodor were different from those found in clinical oral malodor.

Exploring taste hyposensitivity in Japanese senior high school students.

AIM: The main objective of this study was to investigate the prevalence of taste hyposensitivity and the relationships between sex, oral health status, and eating habits with taste hyposensitivity in Japanese senior high school students. METHODS: Oral examinations, sweet and salt whole-mouth taste tests, and a questionnaire about eating habits were conducted on 234 senior high school students. Factors affecting taste hyposensitivity were investigated using a multivariate analysis. RESULTS: Sweet-taste hyposensitivity was observed in 7.3% of the students, and salt-taste hyposensitivity in 22.2%. Approximately 3% of the students had both sweet- and salt-taste hyposensitivity, and 22.6% had either sweet- or salt-taste hyposensitivity. In total, 26% had a taste hyposensitivity. There were significant relationships between the intake of instant noodles with sweet-taste hyposensitivity, and the intake of vegetables or isotonic drinks with salt-taste hyposensitivity. CONCLUSIONS: There was a significant association between eating habits and taste hyposensitivity in Japanese senior high school students. Taste tests would be a helpful adjunct for students to recognize variations in taste sensitivity, and a questionnaire about their eating habits might provide an effective self-review of their eating habits, and therefore, provide motivation to change.

Daily variation of oral malodour and related factors in community-dwelling elderly Thai.

OBJECTIVES: The purposes of this study were (i) to estimate the prevalence of oral malodour, (ii) to evaluate the daily variation of oral malodour and (iii) to assess associations of volatile sulphur compound (VSC) concentrations with socio-demographics, health behaviours and oral health status in community-dwelling elderly Thai. METHODS: The subjects were 428 dentate elderly people (67.6 ± 5.6 years) living in Phitsaulok, Thailand. Information on their socio-demographics, general health and health behaviours was obtained by a questionnaire. Their dental condition, periodontal status and tongue coating were clinically examined. Their flow rates and the pH of unstimulated saliva were also assessed. Oral malodour was measured at four different times of day using an Oral Chroma™. RESULTS: The proportions of subjects diagnosed with oral malodour using the thresholds of H(2)S, CH(3)SH and (CH(3))(2) S were 60.5%, 62.9% and 80.7%, respectively. Concentrations of H(2)S showed significant daily variation. Linear regression analysis demonstrated the following significant associations: (i) oral malodour from H(2)S and thickness of the tongue coating, (ii) oral malodour from CH(3)SH and periodontal pocket depth of 5 mm or more and the presence of gingival bleeding and (iii) oral malodour from (CH(3))(2)S and systemic disease, medications and thickness of the tongue coating. DISCUSSION: Oral malodour was shown to be prevalent among the elderly. Daily variation was observed in the concentration of H(2)S. Tongue coating, periodontal disease, systemic diseases and medications were related to oral malodour. Therefore, these factors should be taken into consideration in oral malodour treatment and prevention programmes for the elderly.

Effects of an oral health education program targeting oral malodor prevention in Japanese senior high school students.

OBJECTIVE: Previous research has suggested that oral malodor could be a useful motivational tool for increasing the awareness of oral health in adolescents and improving their oral health behaviors. Hence, the aims of this research were: (1) to develop an oral health education program that included oral malodor prevention and (2) to test the effects of the program in Japanese senior high school students by comparing the changes of oral health outcomes between the intervention and control groups. MATERIALS AND METHODS: Subjects were 163 Grade 1 and 135 Grade 2 senior high school students in Tokyo, Japan. A novel oral health education program, which incorporated prevention of oral malodor, was developed and conducted on all Grade 1 students (intervention group). Grade 2 students (control group) did not receive the program. Changes in oral health status from baseline to 1-year follow-up were compared between the intervention and control groups. RESULTS: The intervention group, compared with the control group, had a significantly higher proportion of students who improved or maintained good oral health status (i.e. dental plaque, gingivitis, tongue coating and oral malodor). Among students in the intervention group, the change was more evident in subjects with detectable oral malodor at the commencement of the program. CONCLUSIONS: An oral health education program focusing on the prevention of oral malodor is effective for promoting oral health among Japanese senior high school students. Therefore, embedding such a program in the school oral health curriculum would be beneficial for adolescents.